Given the severe complications associated with critical limb ischemia (CLI), this author offers a revealing look at the research on tissue regeneration and stem cell therapy, and potential therapeutic applications in the future.
Critical limb ischemia (CLI) is an end-stage disease that is provoked by progressive obstruction of the peripheral arteries. It is often associated with long segments of involvement at multiple sites with distal vessel disease. The ischemic insult results in rest pain, which progresses to skin breakdown and gangrene unless ischemia is revers... continue reading

There is an ancient Chinese curse that goes, “May you live in interesting times.” We are now living in interesting financial times due to the current global economic mess. The experts and economists are mainly engaged in finger-pointing, which does no good. Others are claiming that they saw it coming. Since the world economy is cyclical, everybody knew it was coming.
I have an advantage for dealing with hard economic times. I grew up in a small town in north central Montana. The economy came to a halt every winter. Unemployment grew to 11 percent. The... continue reading

NPWT Dressing Selection Made Easy
When using negative pressure wound therapy (NPWT) to facilitate wound healing, podiatrists may opt to use a new foam dressing kit.
The new foam dressing kit, which is designed for use with Smith and Nephew’s NPWT devices, enables DPMs to have gauze and foam choices from one manufacturer, according to Smith and Nephew.
Smith and Nephew adds that the dressing kit, a single use product, is available in four sizes. The company says the foam dressing kit is both clinically effective and ... continue reading

APMA Creates New Surgical Affiliate
By Brian McCurdy, Senior Editor
Following the American Podiatric Medical Association’s (APMA) parting of ways with the American College of Foot and Ankle Surgeons (ACFAS), the APMA has established its own new surgical affiliate, the American Society of Podiatric Surgeons (ASPS).
The ASPS has a goal of “promoting the advancement of podiatric surgery through education and research,” according to a recent edition of the APMA e-news. The new surgical affiliate will operate under its own bylaws and will... continue reading

Achilles tendon problems have become more widespread with the increase in the number of adult athletes and an increase in the overall body mass index of patients. There have been many advances in the treatment of Achilles tendon problems with several improvements in conservative care, several so-called “overlap procedures” and multiple new surgical techniques.
In order to understand Achilles issues, we first need to discuss the make-up of the Achilles tendon and the terminology of associated problems. The Achilles complex is made up of several sectio... continue reading

Yes, Tom Chang, DPM cites recent advances in the use of autografts and allografts, and emphasizes that hyaline cartilage is more durable than fibrocartilage.
The last few years have seen the introduction of evolving techniques for osteochondral defects for talar lesions. These techniques include the use of autografts and allografts in single plugs or mosaic patterns.
Surgeons have utilized similar techniques for chondral defects in the metatarsal heads as well. The degenerative changes in patients with hallux valgus or hallux limitus can prese... continue reading

Patients with tendinopathies can undergo conservative care for months without resolution of the condition. Delayed presentation is often an issue as well. Accordingly, this author emphasizes the differences between tendinopathy and tendinosis, and offers salient insights on surgical modalities and procedures.
At podiatric medical conferences, one will see rows and rows of vendors displaying a wide variety of products involving fixation of bone. However, there are very few vendors who display products that foot and ankle surgeons can use in the treatment of tendon... continue reading

Given the challenges of selecting appropriate empiric therapy with the rise of antibiotic resistance, these authors offer a review of the literature in regard to diabetic foot infections. They offer pertinent insights on infection severity, common pathogens and other factors in choosing the right agent.
While antibiotic therapy for infection is typically empiric at the outset, making the right call is not easy. If physicians make a too narrow selection in terms of antibiotic coverage, they may miss the offending organism. Conversely, choosing a too broad antibiotic ... continue reading

Having effective and thorough documentation methods can enhance outcomes, improve efficiency and help reduce hurdles to timely reimbursement. These panelists draw on their experience to discuss exactly what one needs to document in charts and how to use technology to make documentation easier.
Q: What are the recommended methods for the wound care documentation?
A: In addition to documenting patient care, Caroline Fife, MD, notes that the medical record supplies information for quality assurance and the data needed to determine the billed revenue for physi... continue reading